123Patient Management and Education
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Appendix
Reference
Guides
Alarms and
Emergencies
Patient
Management
Surgical
Implant and
Explant
Monitor
Peripherals
and
Accessories
HVAD
®
PumpOverviewIntroduction
7.0 Patient Management and Education
7.1 Postoperative
Management ............123
7.1.1 Setting Speed with HVAD
®
Pump
....................124
7.1.2 Blood Pressure
Maintenance
...........125
7.1.3 Anticoagulation ........ 125
7.1.4 Right Heart Failure ...126
7.1.5 Arrhythmias ............126
7.1.6 Infection Control
Guidelines
..............126
7.2 Driveline Care ...........127
7.3 Emergency
Management ............128
7.4 Physical
Rehabilitation ...........128
7.5 Patient Education ....128
7.1 Postoperative Management
After implantation, the patient is returned to the intensive
2
with
central venous pressure and left atrial pressure less than
20 mmHg. Some vasopressor and/or vasodilatory
pharmacologic assistance can be used as required to
adjust vasomotor tone. Patients may require inotropic
assistance to improve right ventricular function.
WARNING! Data has shown that appropriate patient
management can mitigate this risk. The following patient
management guidelines should be adopted:
Monitor and treat mean arterial pressure. Maintain
MAP less than 85 mmHg as tolerated.
Speed on the HVAD
®
Pump should be set to maintain
need exceed 2.6 L/min/m
2
. Maintain anticoagulation
Maintain anticoagulation within the recommended
inhibition should be evaluated and adjust ASA
monotherapy accordingly or consider combination
therapy such as ASA 81 mg plus Aggrenox
®
(ASA plus
extended– release dipyridamole) or daily ASA 81 mg
plus Plavix 75 mg.
Check for ASA resistance with a reliable test (e.g.
®
) and adjust ASA mono-therapy
accordingly or consider combination therapy such as
ASA 81 mg plus Aggrenox
®
(ASA plus extended –
release dipyridamole) or daily ASA 81 mg plus Plavix 75
mg. In general, mono-therapy with ASA is not
encouraged in the absence of testing for resistance.
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